36 patients (mean age 40+11 years) with vertebral artery dissections associated with chiropractic neck manipulation were identified in neurological departments at university hospitals in Germany. 90% of patients admitted to hospital showed focal neurological deficits and among these 11% had a reduced level of consciousness. 50% of subjects were discharged after 20+/-14 hospital days with focal neurological deficits, one patient died and one was in a persistent vegetative state. Risk factors associated with artery dissections (e.g. fibromuscular dysplasia) were present in only 25% of subjects. Reuter U, Hamling M, Kavuk I, Einhaupl K M, Schielke E; for the German vertebral artery dissection study group. Journal of Neurology (March 2006) [pdf]